|
HC PRESBYOPIA LENS
|
Facility
|
IP
|
$3,586.48
|
|
|
Service Code
|
HCPCS C1780
|
| Hospital Charge Code |
27600001
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$2,187.39 |
| Max. Negotiated Rate |
$3,227.83 |
| Rate for Payer: Aetna Commercial |
$3,048.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,771.63
|
| Rate for Payer: BCN Commercial |
$2,771.63
|
| Rate for Payer: Cash Price |
$2,869.18
|
| Rate for Payer: Cofinity Commercial |
$3,084.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,869.18
|
| Rate for Payer: Healthscope Commercial |
$3,227.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,689.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,048.51
|
| Rate for Payer: PHP Commercial |
$3,048.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,510.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,120.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,187.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,156.10
|
| Rate for Payer: UHC Core |
$2,994.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,689.86
|
|
|
HC PRESSURE WIRE
|
Facility
|
OP
|
$2,158.09
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$512.55 |
| Max. Negotiated Rate |
$1,942.28 |
| Rate for Payer: Aetna Commercial |
$1,834.38
|
| Rate for Payer: Aetna Medicare |
$561.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$674.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$674.40
|
| Rate for Payer: BCBS Complete |
$863.24
|
| Rate for Payer: BCBS MAPPO |
$539.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,677.91
|
| Rate for Payer: BCN Commercial |
$1,677.91
|
| Rate for Payer: BCN Medicare Advantage |
$539.52
|
| Rate for Payer: Cash Price |
$1,726.47
|
| Rate for Payer: Cofinity Commercial |
$1,855.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,726.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$539.52
|
| Rate for Payer: Healthscope Commercial |
$1,942.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,618.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$566.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$620.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,834.38
|
| Rate for Payer: PACE Senior Care Partners |
$512.55
|
| Rate for Payer: PACE SWMI |
$539.52
|
| Rate for Payer: PHP Commercial |
$1,834.38
|
| Rate for Payer: PHP Medicare Advantage |
$539.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,877.54
|
| Rate for Payer: Priority Health Medicare |
$539.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,316.22
|
| Rate for Payer: Railroad Medicare Medicare |
$539.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,899.12
|
| Rate for Payer: UHC Core |
$1,802.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$539.52
|
| Rate for Payer: UHC Medicare Advantage |
$555.71
|
| Rate for Payer: VA VA |
$539.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,618.57
|
|
|
HC PRESSURE WIRE
|
Facility
|
IP
|
$2,158.09
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,316.22 |
| Max. Negotiated Rate |
$1,942.28 |
| Rate for Payer: Aetna Commercial |
$1,834.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,667.77
|
| Rate for Payer: BCN Commercial |
$1,667.77
|
| Rate for Payer: Cash Price |
$1,726.47
|
| Rate for Payer: Cofinity Commercial |
$1,855.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,726.47
|
| Rate for Payer: Healthscope Commercial |
$1,942.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,618.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,834.38
|
| Rate for Payer: PHP Commercial |
$1,834.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,877.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,316.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,899.12
|
| Rate for Payer: UHC Core |
$1,802.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,618.57
|
|
|
HC PRESUMPTIVE DRUG TEST CHEM ANALYZER
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.21 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: BCBS Trust/PPO |
$78.83
|
| Rate for Payer: BCN Commercial |
$78.83
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.76
|
| Rate for Payer: UHC Core |
$85.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
|
HC PRESUMPTIVE DRUG TEST CHEM ANALYZER
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.22 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: Aetna Medicare |
$26.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.88
|
| Rate for Payer: BCBS Complete |
$48.15
|
| Rate for Payer: BCBS MAPPO |
$25.50
|
| Rate for Payer: BCBS Trust/PPO |
$79.30
|
| Rate for Payer: BCN Commercial |
$79.30
|
| Rate for Payer: BCN Medicare Advantage |
$25.50
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.50
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$48.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: PACE Senior Care Partners |
$24.22
|
| Rate for Payer: PACE SWMI |
$25.50
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: PHP Medicare Advantage |
$25.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.74
|
| Rate for Payer: Priority Health Medicare |
$25.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.21
|
| Rate for Payer: Railroad Medicare Medicare |
$25.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.76
|
| Rate for Payer: UHC Core |
$85.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.50
|
| Rate for Payer: UHC Medicare Advantage |
$26.26
|
| Rate for Payer: VA VA |
$25.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
|
HC PRESUMPTIVE DRUG TEST OPTICAL
|
Facility
|
IP
|
$50.49
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100728
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.79 |
| Max. Negotiated Rate |
$45.44 |
| Rate for Payer: Aetna Commercial |
$42.92
|
| Rate for Payer: BCBS Trust/PPO |
$39.02
|
| Rate for Payer: BCN Commercial |
$39.02
|
| Rate for Payer: Cash Price |
$40.39
|
| Rate for Payer: Cofinity Commercial |
$43.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.39
|
| Rate for Payer: Healthscope Commercial |
$45.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.92
|
| Rate for Payer: PHP Commercial |
$42.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.43
|
| Rate for Payer: UHC Core |
$42.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.87
|
|
|
HC PRESUMPTIVE DRUG TEST OPTICAL
|
Facility
|
OP
|
$50.49
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100728
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.30 |
| Max. Negotiated Rate |
$45.44 |
| Rate for Payer: Aetna Commercial |
$42.92
|
| Rate for Payer: Aetna Medicare |
$13.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.78
|
| Rate for Payer: BCBS Complete |
$9.76
|
| Rate for Payer: BCBS MAPPO |
$12.62
|
| Rate for Payer: BCBS Trust/PPO |
$39.26
|
| Rate for Payer: BCN Commercial |
$39.26
|
| Rate for Payer: BCN Medicare Advantage |
$12.62
|
| Rate for Payer: Cash Price |
$40.39
|
| Rate for Payer: Cash Price |
$40.39
|
| Rate for Payer: Cofinity Commercial |
$43.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.62
|
| Rate for Payer: Healthscope Commercial |
$45.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.87
|
| Rate for Payer: Mclaren Medicaid |
$9.30
|
| Rate for Payer: Meridian Medicaid |
$9.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.92
|
| Rate for Payer: PACE Senior Care Partners |
$11.99
|
| Rate for Payer: PACE SWMI |
$12.62
|
| Rate for Payer: PHP Commercial |
$42.92
|
| Rate for Payer: PHP Medicare Advantage |
$12.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.93
|
| Rate for Payer: Priority Health Medicare |
$12.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.79
|
| Rate for Payer: Railroad Medicare Medicare |
$12.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.43
|
| Rate for Payer: UHC Core |
$42.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.62
|
| Rate for Payer: UHC Medicare Advantage |
$13.00
|
| Rate for Payer: VA VA |
$12.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.87
|
|
|
HC PRIMARY MEMBRANOUS NEPH DX CASCADE S
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100757
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$126.25 |
| Max. Negotiated Rate |
$186.30 |
| Rate for Payer: Aetna Commercial |
$175.95
|
| Rate for Payer: BCBS Trust/PPO |
$159.97
|
| Rate for Payer: BCN Commercial |
$159.97
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cofinity Commercial |
$178.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.60
|
| Rate for Payer: Healthscope Commercial |
$186.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.95
|
| Rate for Payer: PHP Commercial |
$175.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.16
|
| Rate for Payer: UHC Core |
$172.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.25
|
|
|
HC PRIMARY MEMBRANOUS NEPH DX CASCADE S
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100757
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$186.30 |
| Rate for Payer: Aetna Commercial |
$175.95
|
| Rate for Payer: Aetna Medicare |
$53.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.69
|
| Rate for Payer: BCBS Complete |
$13.38
|
| Rate for Payer: BCBS MAPPO |
$51.75
|
| Rate for Payer: BCBS Trust/PPO |
$160.94
|
| Rate for Payer: BCN Commercial |
$160.94
|
| Rate for Payer: BCN Medicare Advantage |
$51.75
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cofinity Commercial |
$178.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.75
|
| Rate for Payer: Healthscope Commercial |
$186.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.25
|
| Rate for Payer: Mclaren Medicaid |
$12.75
|
| Rate for Payer: Meridian Medicaid |
$13.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$54.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.95
|
| Rate for Payer: PACE Senior Care Partners |
$49.16
|
| Rate for Payer: PACE SWMI |
$51.75
|
| Rate for Payer: PHP Commercial |
$175.95
|
| Rate for Payer: PHP Medicare Advantage |
$51.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.09
|
| Rate for Payer: Priority Health Medicare |
$51.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.25
|
| Rate for Payer: Railroad Medicare Medicare |
$51.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.16
|
| Rate for Payer: UHC Core |
$172.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.75
|
| Rate for Payer: UHC Medicare Advantage |
$53.30
|
| Rate for Payer: VA VA |
$51.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.25
|
|
|
HC PRIMIDONE MYSOLINE LEVEL
|
Facility
|
OP
|
$26.52
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$23.87 |
| Rate for Payer: Aetna Commercial |
$22.54
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$11.86
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.62
|
| Rate for Payer: BCN Commercial |
$20.62
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.89
|
| Rate for Payer: Mclaren Medicaid |
$11.29
|
| Rate for Payer: Meridian Medicaid |
$11.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.54
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.54
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.07
|
| Rate for Payer: Priority Health Medicare |
$6.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.17
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.34
|
| Rate for Payer: UHC Core |
$22.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.63
|
| Rate for Payer: UHC Medicare Advantage |
$6.83
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.89
|
|
|
HC PRIMIDONE MYSOLINE LEVEL
|
Facility
|
IP
|
$26.52
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.17 |
| Max. Negotiated Rate |
$23.87 |
| Rate for Payer: Aetna Commercial |
$22.54
|
| Rate for Payer: BCBS Trust/PPO |
$20.49
|
| Rate for Payer: BCN Commercial |
$20.49
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.54
|
| Rate for Payer: PHP Commercial |
$22.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.34
|
| Rate for Payer: UHC Core |
$22.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.89
|
|
|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
IP
|
$37.74
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.02 |
| Max. Negotiated Rate |
$33.97 |
| Rate for Payer: Aetna Commercial |
$32.08
|
| Rate for Payer: BCBS Trust/PPO |
$29.17
|
| Rate for Payer: BCN Commercial |
$29.17
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$32.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Healthscope Commercial |
$33.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.08
|
| Rate for Payer: PHP Commercial |
$32.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.21
|
| Rate for Payer: UHC Core |
$31.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.30
|
|
|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
OP
|
$37.74
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.96 |
| Max. Negotiated Rate |
$33.97 |
| Rate for Payer: Aetna Commercial |
$32.08
|
| Rate for Payer: Aetna Medicare |
$9.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.79
|
| Rate for Payer: BCBS Complete |
$12.86
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCBS Trust/PPO |
$29.34
|
| Rate for Payer: BCN Commercial |
$29.34
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$32.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Healthscope Commercial |
$33.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.30
|
| Rate for Payer: Mclaren Medicaid |
$12.24
|
| Rate for Payer: Meridian Medicaid |
$12.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.08
|
| Rate for Payer: PACE Senior Care Partners |
$8.96
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Commercial |
$32.08
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.83
|
| Rate for Payer: Priority Health Medicare |
$9.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.02
|
| Rate for Payer: Railroad Medicare Medicare |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.21
|
| Rate for Payer: UHC Core |
$31.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.44
|
| Rate for Payer: UHC Medicare Advantage |
$9.72
|
| Rate for Payer: VA VA |
$9.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.30
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$248.00
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$151.26 |
| Max. Negotiated Rate |
$223.20 |
| Rate for Payer: Aetna Commercial |
$210.80
|
| Rate for Payer: BCBS Trust/PPO |
$191.65
|
| Rate for Payer: BCN Commercial |
$191.65
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cofinity Commercial |
$213.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.40
|
| Rate for Payer: Healthscope Commercial |
$223.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$210.80
|
| Rate for Payer: PHP Commercial |
$210.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.24
|
| Rate for Payer: UHC Core |
$207.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.00
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$248.00
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$58.47 |
| Max. Negotiated Rate |
$223.20 |
| Rate for Payer: Aetna Commercial |
$210.80
|
| Rate for Payer: Aetna Medicare |
$64.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.50
|
| Rate for Payer: BCBS Complete |
$61.40
|
| Rate for Payer: BCBS MAPPO |
$62.00
|
| Rate for Payer: BCBS Trust/PPO |
$192.82
|
| Rate for Payer: BCN Commercial |
$192.82
|
| Rate for Payer: BCN Medicare Advantage |
$62.00
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cofinity Commercial |
$213.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.00
|
| Rate for Payer: Healthscope Commercial |
$223.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.00
|
| Rate for Payer: Mclaren Medicaid |
$58.47
|
| Rate for Payer: Meridian Medicaid |
$61.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$210.80
|
| Rate for Payer: PACE Senior Care Partners |
$58.90
|
| Rate for Payer: PACE SWMI |
$62.00
|
| Rate for Payer: PHP Commercial |
$210.80
|
| Rate for Payer: PHP Medicare Advantage |
$62.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.76
|
| Rate for Payer: Priority Health Medicare |
$62.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.26
|
| Rate for Payer: Railroad Medicare Medicare |
$62.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.24
|
| Rate for Payer: UHC Core |
$207.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.00
|
| Rate for Payer: UHC Medicare Advantage |
$63.86
|
| Rate for Payer: VA VA |
$62.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.00
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$190.00
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$115.88 |
| Max. Negotiated Rate |
$171.00 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| Rate for Payer: BCBS Trust/PPO |
$146.83
|
| Rate for Payer: BCN Commercial |
$146.83
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$163.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.00
|
| Rate for Payer: Healthscope Commercial |
$171.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.50
|
| Rate for Payer: PHP Commercial |
$161.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.20
|
| Rate for Payer: UHC Core |
$158.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.50
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$190.00
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$45.12 |
| Max. Negotiated Rate |
$171.00 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| Rate for Payer: Aetna Medicare |
$49.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.38
|
| Rate for Payer: BCBS Complete |
$76.00
|
| Rate for Payer: BCBS MAPPO |
$47.50
|
| Rate for Payer: BCBS Trust/PPO |
$147.72
|
| Rate for Payer: BCN Commercial |
$147.72
|
| Rate for Payer: BCN Medicare Advantage |
$47.50
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$163.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.50
|
| Rate for Payer: Healthscope Commercial |
$171.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$49.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.50
|
| Rate for Payer: PACE Senior Care Partners |
$45.12
|
| Rate for Payer: PACE SWMI |
$47.50
|
| Rate for Payer: PHP Commercial |
$161.50
|
| Rate for Payer: PHP Medicare Advantage |
$47.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.30
|
| Rate for Payer: Priority Health Medicare |
$47.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.88
|
| Rate for Payer: Railroad Medicare Medicare |
$47.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.20
|
| Rate for Payer: UHC Core |
$158.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.50
|
| Rate for Payer: UHC Medicare Advantage |
$48.92
|
| Rate for Payer: VA VA |
$47.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.50
|
|
|
HC PRO BNP
|
Facility
|
OP
|
$151.20
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
30100304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$136.08 |
| Rate for Payer: Aetna Commercial |
$128.52
|
| Rate for Payer: Aetna Medicare |
$39.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.25
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS MAPPO |
$37.80
|
| Rate for Payer: BCBS Trust/PPO |
$117.56
|
| Rate for Payer: BCN Commercial |
$117.56
|
| Rate for Payer: BCN Medicare Advantage |
$37.80
|
| Rate for Payer: Cash Price |
$120.96
|
| Rate for Payer: Cash Price |
$120.96
|
| Rate for Payer: Cofinity Commercial |
$130.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.80
|
| Rate for Payer: Healthscope Commercial |
$136.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.40
|
| Rate for Payer: Mclaren Medicaid |
$28.97
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.52
|
| Rate for Payer: PACE Senior Care Partners |
$35.91
|
| Rate for Payer: PACE SWMI |
$37.80
|
| Rate for Payer: PHP Commercial |
$128.52
|
| Rate for Payer: PHP Medicare Advantage |
$37.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.54
|
| Rate for Payer: Priority Health Medicare |
$37.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.22
|
| Rate for Payer: Railroad Medicare Medicare |
$37.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.06
|
| Rate for Payer: UHC Core |
$126.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.80
|
| Rate for Payer: UHC Medicare Advantage |
$38.93
|
| Rate for Payer: VA VA |
$37.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.40
|
|
|
HC PRO BNP
|
Facility
|
IP
|
$151.20
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
30100304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$92.22 |
| Max. Negotiated Rate |
$136.08 |
| Rate for Payer: Aetna Commercial |
$128.52
|
| Rate for Payer: BCBS Trust/PPO |
$116.85
|
| Rate for Payer: BCN Commercial |
$116.85
|
| Rate for Payer: Cash Price |
$120.96
|
| Rate for Payer: Cofinity Commercial |
$130.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.96
|
| Rate for Payer: Healthscope Commercial |
$136.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.52
|
| Rate for Payer: PHP Commercial |
$128.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.06
|
| Rate for Payer: UHC Core |
$126.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.40
|
|
|
HC PROCAINAMIDE AND NAPA LEVEL
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 80192
|
| Hospital Charge Code |
30100042
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.36 |
| Max. Negotiated Rate |
$60.30 |
| Rate for Payer: Aetna Commercial |
$56.95
|
| Rate for Payer: Aetna Medicare |
$17.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.94
|
| Rate for Payer: BCBS Complete |
$12.98
|
| Rate for Payer: BCBS MAPPO |
$16.75
|
| Rate for Payer: BCBS Trust/PPO |
$52.09
|
| Rate for Payer: BCN Commercial |
$52.09
|
| Rate for Payer: BCN Medicare Advantage |
$16.75
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$57.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.75
|
| Rate for Payer: Healthscope Commercial |
$60.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.25
|
| Rate for Payer: Mclaren Medicaid |
$12.36
|
| Rate for Payer: Meridian Medicaid |
$12.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.95
|
| Rate for Payer: PACE Senior Care Partners |
$15.91
|
| Rate for Payer: PACE SWMI |
$16.75
|
| Rate for Payer: PHP Commercial |
$56.95
|
| Rate for Payer: PHP Medicare Advantage |
$16.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.29
|
| Rate for Payer: Priority Health Medicare |
$16.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.86
|
| Rate for Payer: Railroad Medicare Medicare |
$16.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.96
|
| Rate for Payer: UHC Core |
$55.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.75
|
| Rate for Payer: UHC Medicare Advantage |
$17.25
|
| Rate for Payer: VA VA |
$16.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.25
|
|
|
HC PROCAINAMIDE AND NAPA LEVEL
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 80192
|
| Hospital Charge Code |
30100042
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.86 |
| Max. Negotiated Rate |
$60.30 |
| Rate for Payer: Aetna Commercial |
$56.95
|
| Rate for Payer: BCBS Trust/PPO |
$51.78
|
| Rate for Payer: BCN Commercial |
$51.78
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$57.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.60
|
| Rate for Payer: Healthscope Commercial |
$60.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.95
|
| Rate for Payer: PHP Commercial |
$56.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.96
|
| Rate for Payer: UHC Core |
$55.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.25
|
|
|
HC PROCAINAMIDE CHALLENGE
|
Facility
|
OP
|
$7,278.36
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100123
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$102.47 |
| Max. Negotiated Rate |
$6,550.52 |
| Rate for Payer: Aetna Commercial |
$6,186.61
|
| Rate for Payer: Aetna Medicare |
$1,892.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,274.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,274.49
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$1,819.59
|
| Rate for Payer: BCBS Trust/PPO |
$5,658.92
|
| Rate for Payer: BCN Commercial |
$5,658.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,819.59
|
| Rate for Payer: Cash Price |
$5,822.69
|
| Rate for Payer: Cash Price |
$5,822.69
|
| Rate for Payer: Cofinity Commercial |
$6,259.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,822.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,819.59
|
| Rate for Payer: Healthscope Commercial |
$6,550.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,458.77
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,910.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,092.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,186.61
|
| Rate for Payer: PACE Senior Care Partners |
$1,728.61
|
| Rate for Payer: PACE SWMI |
$1,819.59
|
| Rate for Payer: PHP Commercial |
$6,186.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,819.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,094.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,332.17
|
| Rate for Payer: Priority Health Medicare |
$1,819.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,439.07
|
| Rate for Payer: Railroad Medicare Medicare |
$1,819.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,404.96
|
| Rate for Payer: UHC Core |
$6,077.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,819.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,874.18
|
| Rate for Payer: VA VA |
$1,819.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,458.77
|
|
|
HC PROCAINAMIDE CHALLENGE
|
Facility
|
IP
|
$7,278.36
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100123
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,439.07 |
| Max. Negotiated Rate |
$6,550.52 |
| Rate for Payer: Aetna Commercial |
$6,186.61
|
| Rate for Payer: BCBS Trust/PPO |
$5,624.72
|
| Rate for Payer: BCN Commercial |
$5,624.72
|
| Rate for Payer: Cash Price |
$5,822.69
|
| Rate for Payer: Cofinity Commercial |
$6,259.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,822.69
|
| Rate for Payer: Healthscope Commercial |
$6,550.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,458.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,186.61
|
| Rate for Payer: PHP Commercial |
$6,186.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,094.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,332.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,439.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,404.96
|
| Rate for Payer: UHC Core |
$6,077.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,458.77
|
|
|
HC PROCALCITONIN
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
30100480
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.21 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: BCBS Trust/PPO |
$78.83
|
| Rate for Payer: BCN Commercial |
$78.83
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.76
|
| Rate for Payer: UHC Core |
$85.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
|
HC PROCALCITONIN
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
30100480
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.09 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: Aetna Medicare |
$26.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.88
|
| Rate for Payer: BCBS Complete |
$21.09
|
| Rate for Payer: BCBS MAPPO |
$25.50
|
| Rate for Payer: BCBS Trust/PPO |
$79.30
|
| Rate for Payer: BCN Commercial |
$79.30
|
| Rate for Payer: BCN Medicare Advantage |
$25.50
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.50
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Mclaren Medicaid |
$20.09
|
| Rate for Payer: Meridian Medicaid |
$21.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: PACE Senior Care Partners |
$24.22
|
| Rate for Payer: PACE SWMI |
$25.50
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: PHP Medicare Advantage |
$25.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.74
|
| Rate for Payer: Priority Health Medicare |
$25.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.21
|
| Rate for Payer: Railroad Medicare Medicare |
$25.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.76
|
| Rate for Payer: UHC Core |
$85.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.50
|
| Rate for Payer: UHC Medicare Advantage |
$26.26
|
| Rate for Payer: VA VA |
$25.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
